The U.S. is launching 1 of the largest hospital building booms in its history, with $16 billion of construction in 2004 and more than $200 billion projected over the next 10 years. There is growing evidence that appropriate design of the physical environment of hospitals can increase the quality, safety, efficiency and effectiveness of healthcare. For example, a recent review by Ulrich, Zimring, and others (Appendix 1) found over 650 rigorous studies establishing that the design of the physical environment of hospitals directly impacts AHRQ's key goals. To summarize, appropriate design can: 1. Reduce staff stress and fatigue and increase effectiveness in delivering care. 2. Improve patient safety by reducing medical errors, infections and falls. 3. Increase patient-centeredness by reducing patient and family stress and improving patient outcomes. 4. Improve overall healthcare quality. However, while the volume of evidence linking hospital design to patient and staff outcome is encouraging, the research is scattered, opportunistic and idiosyncratic. Little of it focuses specifically on priority populations such as minorities, women and children. And while the amount of research is increasing, the infrastructure is not yet in place to create an active, rigorous and high impact field. There are few mechanisms to fund, publish or evaluate research. There is no reliable pipeline to carry evidence forward to decision-making or education. Dissemination is limited. This proposed small conference, to be held September 14-15, 2005, will inform key researchers, research consumers and decision-makers of the depth and breadth of the evidence and will identify the measures needed to foster a vigorous and effective new field in time to impact the large volume of hospital construction. These hospitals will be built anyway, with or without evidence supporting their design. They will be built either with designs that increase stress and danger for patients, family and staff or with designs that enable effective, efficient, safe, and patient-centered care. In either case, the physical form of hospitals will shape U.S. healthcare for years to come. Conference results will be disseminated via journal articles, web sites and press releases.